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BMJ Open May 2024The COVID-19 pandemic highlighted the fragility of immunisation programmes and resulted in a significant reduction in vaccination rates, with increasing... (Review)
Review
OBJECTIVES
The COVID-19 pandemic highlighted the fragility of immunisation programmes and resulted in a significant reduction in vaccination rates, with increasing vaccine-preventable disease outbreaks consequently reported. These vulnerabilities underscore the importance of resilient immunisation programmes to ensure optimal performance during crises. To date, a framework for assessing immunisation programme resilience does not exist. We conducted a scoping review of immunisation programmes during times of crisis to identify factors that characterise resilient immunisation programmes, which may inform an Immunisation Programme Resilience Tool.
DESIGN
Scoping review design followed the Arksey and O'Malley framework, and manuscript reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews guidelines.
DATA SOURCES
CINAHL, CENTRAL, Embase, Google Scholar, MEDLINE, PsycINFO and Web of Science and databases were searched between 1 January 2011 and 2 September 2023. Citation searching of identified studies was also performed.
ELIGIBILITY CRITERIA
We included primary empirical peer-reviewed studies that discussed the resilience of immunisation programme to crises, shocks or disruptions.
DATA EXTRACTION AND SYNTHESIS
Two independent reviewers screened records and performed data extraction. We extracted data on study location and design, crisis description, and resilience characteristics discussed, and identified evidence gaps in the literature. Findings were synthesised using tabulation and an evidence gap map.
RESULTS
Thirty-seven studies met the eligibility criteria. These studies captured research conducted across six continents, with most concentrated in Africa, Asia and Europe. One study had a randomised controlled trial design, while 36 studies had observational designs (15 analytical and 21 descriptive). We identified five characteristics of resilient immunisation programmes drawing on the Health System Resilience Index (Integration, Awareness, Resource Availability and Access, Adaptiveness and Self-regulation) and several evidence gaps in the literature.
CONCLUSIONS
To our knowledge, no immunisation programme resilience tool exists. We identified factors from the Health System Resilience Index coupled with factors identified through primary empirical evidence, which may inform development of an immunisation programme resilience tool.
Topics: Humans; Immunization Programs; COVID-19; SARS-CoV-2; Pandemics; Vaccination
PubMed: 38806437
DOI: 10.1136/bmjopen-2023-072794 -
Hand Clinics Aug 2023The proper technique for flexor tendon repair has been well established through numerous bench science and clinical studies. However, less is known about strategies to... (Review)
Review
The proper technique for flexor tendon repair has been well established through numerous bench science and clinical studies. However, less is known about strategies to avoid and manage postoperative complications. This article discusses the common complications after flexor tendon repair, such as repair site rupture and adhesion formation. This article also addresses strategies to prevent and manage these complications. The foundation for preventing many of these complications is ensuring a strong repair without gapping at time zero, which will enable the accrual of tensile strength through early initiation of motion.
Topics: Humans; Tendon Injuries; Tendons; Rupture; Range of Motion, Articular; Postoperative Complications; Tensile Strength; Suture Techniques; Biomechanical Phenomena
PubMed: 37453769
DOI: 10.1016/j.hcl.2023.03.003 -
Virus Genes Aug 2023Mumps is a vaccine-preventable disease, and research on the vaccine's efficacy has recently indicated declining efficacy that has failed to protect against primary...
Mumps is a vaccine-preventable disease, and research on the vaccine's efficacy has recently indicated declining efficacy that has failed to protect against primary infections or reinfections, leading to a global resurgence in nations that use mumps vaccine in their national immunization programmes (NIPs). Lack of reports on its infection, documentation and published studies prevents it from being recognized as a public health issue in India. The waning of immunity is ascribed to the changes between the circulating and vaccine strains. The goal of the current study was to describe the circulating MuV strains in the Dibrugarh district of Assam, India, from 2016 to 2019. Blood samples were examined for IgM antibodies, and throat swab samples were put through Taqman assay for molecular detection. The small hydrophobic (SH) gene was targeted for genotyping through sequencing, and its genetic variations and phylogenetic analysis were carried out. Mumps RNA was found in 42 cases, and Mumps IgM in 14, of which 60% (25/42) of the cases were male and 40% (17/42) were female mostly affecting children between the ages of 6 and 12. Sequence and phylogeny analyses of SH gene revealed Genotypes C (83%) and G (17%) were simultaneously circulating during the study period. The study offers crucial genetic baseline information for the creation of Mumps prevention and control measures. Therefore, based on the research, it is clear that developing an effective vaccination strategy should take into account all currently prevalent genotypes in order to provide better protection against the disease's comeback.
Topics: Child; Male; Humans; Female; Mumps virus; Mumps; Phylogeny; RNA, Viral; Genotype; India; Immunoglobulin M; Vaccines
PubMed: 37133580
DOI: 10.1007/s11262-023-02000-3 -
The International Journal of Behavioral... Jul 2023Cardiovascular diseases (CVD) are the leading cause of death globally. The current model of care for high-income countries involves preventive medication and highly... (Review)
Review
Practical dietary interventions to prevent cardiovascular disease suitable for implementation in primary care: an ADAPTE-guided systematic review of international clinical guidelines.
PURPOSE
Cardiovascular diseases (CVD) are the leading cause of death globally. The current model of care for high-income countries involves preventive medication and highly trained healthcare professionals, which is expensive and not transposable to low-income countries. An innovative, effective approach adapted to limited human, technical, and financial resources is required. Measures to reduce CVD risk factors, including diet, are proven to be effective. The survey "Scaling-up Packages of Interventions for Cardiovascular disease prevention in selected sites in Europe and Sub-Saharan Africa" aims to develop non-pharmacological cardiovascular prevention and control programs in primary care and community settings in high, middle, and low-income countries. This review aims to identify the existing, validated dietary interventions for primary CVD prevention from national and international clinical guidelines that can be implemented in primary care and communities.
METHODS
A systematic review of CVD prevention guidelines was conducted between September 2017 and March 2023 using the Turning Research Into Practice medical database, the Guidelines International Network, and a purposive search. The ADAPTE procedure was followed. Two researchers independently conducted the searches and appraisals. Guidelines published after 01/01/2012 addressing non-pharmacological, dietary interventions for primary CVD prevention or CVD risk factor management, in the adult general population in primary care or in community settings were included and appraised using the Appraisal of Guidelines Research and Evaluation II score. Individual dietary recommendations and the studies supporting them were extracted. Then supporting data about each specific dietary intervention were extracted into a matrix.
RESULTS
In total, 1375 guidelines were identified, of which 39 were included. From these, 383 recommendations, covering 10 CVD prevention themes were identified. From these recommendations, 165 studies for effective dietary interventions for CVD prevention were found. Among these, the DASH diet was the most effective on multiple CVD risk factors. Combining diet with other interventions such as exercise and smoking cessation increased efficacy. No guidelines provided detailed implementation strategies.
CONCLUSION
The DASH diet combined with other interventions was the most effective on an individual basis. However, expansion in the wider population seems difficult, without government support to implement regulations such as reducing salt content in processed food.
TRIAL REGISTRATION
Clinical Trials NCT03886064.
Topics: Adult; Humans; Cardiovascular Diseases; Diet; Risk Factors; Exercise; Primary Health Care
PubMed: 37507692
DOI: 10.1186/s12966-023-01463-9 -
International Journal of Gynaecology... Sep 2023Numerous interventions to reduce perineal trauma during childbirth have been studied in recent years, including perineal massage. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Numerous interventions to reduce perineal trauma during childbirth have been studied in recent years, including perineal massage.
OBJECTIVE
To determine the efficacy of perineal massage during the second stage of labor to prevent perineal damage.
SEARCH STRATEGY
Systematic search in PubMed, Pedro, Scopus, Web of Science, ScienceDirect, BioMed, SpringerLink, EBSCOhost, CINAHL, and MEDLINE with the terms Massage, Second labor stage, Obstetric delivery, and Parturition.
SELECTION CRITERIA
The articles must have been published in the last 10 years; the perineal massage was administered to the study sample; and the experimental design consisted of randomized controlled trial.
DATA COLLECTION AND ANALYSIS
Tables were used to describe both the studies' characteristics and the extracted data. The PEDro and Jadad scales were used to assess the quality of studies.
MAIN RESULTS
Of the 1172 total results identified, nine were selected. Seven studies were included in the meta-analysis and indicated a statistically significant decreased number of episiotomies in perineal massage.
CONCLUSIONS
Massage during the second stage of labor appears to be effective in preventing episiotomies and reducing the duration of the second stage of labor. However, it does not appear to be effective in reducing the incidence and severity of perineal tears.
Topics: Humans; Female; Pregnancy; Lacerations; Labor Stage, Second; Massage; Delivery, Obstetric; Parturition; Perineum; Obstetric Labor Complications
PubMed: 36808391
DOI: 10.1002/ijgo.14723 -
The Journal of Headache and Pain Jul 2023Insights into the burden, needs and treatment of migraine from internet-based surveys in diverse real-world migraine populations are needed, especially at a time when... (Review)
Review
BACKGROUND
Insights into the burden, needs and treatment of migraine from internet-based surveys in diverse real-world migraine populations are needed, especially at a time when novel preventive migraine medications are becoming part of the therapeutic armamentarium. The objectives of this analysis are to describe traditional preventive (orals and onabotulinum toxin A) treatment patterns in the OVERCOME (EU) study migraine cohort, as well as treatment patterns and patient satisfaction with current treatment in a subgroup of respondents eligible for migraine preventive medication.
METHODS
The cross-sectional non-interventional OVERCOME (EU) study was conducted (October 2020-February 2021) via an online survey among adults (aged ≥ 18 years) resident in Germany or Spain. Participants, registered in existing online panels, who were willing to provide consent were considered. The migraine cohort included participants reporting headache/migraine in the past year, identified based on a validated migraine diagnostic questionnaire and/or self-reported physician diagnosis. A subgroup of survey respondents defined as eligible for migraine preventive medication at the point in time the cross-sectional survey was taken was also analysed. Variables assessed included sociodemographic and migraine-related clinical characteristics, preventive (traditional and calcitonin gene-related peptide monoclonal antibodies) treatment patterns and patient satisfaction with current treatment. Results are descriptive only.
RESULTS
Of the 20,756 participants in the migraine cohort, 78.5% sought professional medical care, 50.8% received a migraine diagnosis and only 17.7% had ever used preventive medication. Half (53.3%) of participants currently using preventives took their most recent medication for six months or less. Most patients (73.9%) classified as eligible for preventive medication (based on headache frequency and/or at least moderate disability due to migraine) reported not using traditional preventives and many of those who did (66.8%) were not satisfied with their current standard of care.
CONCLUSIONS
Our findings highlight the low proportion of people diagnosed with migraine despite a higher rate of consultation and suggest the need for better access to treatment for people with migraine and new preventive therapies with improved efficacy and safety profiles to improve adherence and patient satisfaction.
Topics: Adult; Humans; Cross-Sectional Studies; Patient Satisfaction; Migraine Disorders; Surveys and Questionnaires; Headache
PubMed: 37460942
DOI: 10.1186/s10194-023-01623-z -
Prostaglandins & Other Lipid Mediators Aug 2023Stroke and dementia are global leading causes of neurological disability and death. The pathology of these diseases is interrelated and they share common, modifiable... (Review)
Review
Stroke and dementia are global leading causes of neurological disability and death. The pathology of these diseases is interrelated and they share common, modifiable risk factors. It is suggested that docosahexaenoic acid (DHA) prevents neurological and vascular disorders induced by ischemic stroke and also prevent dementia. The purpose of this study was to review the potential preventative role of DHA against ischemic stroke-induced vascular dementia and Alzheimer's disease. In this review, I analyzed studies on stroke-induced dementia from the PubMed, ScienceDirect, and Web of Science databases as well as studies on the effects of DHA on stroke-induced dementia. As per the results of interventional studies, DHA intake can potentially ameliorate dementia and cognitive function. In particular, DHA derived from foods such as fish oil enters the blood and then migrates to the brain by binding to fatty acid binding protein 5 that is present in cerebral vascular endothelial cells. At this point, the esterified form of DHA produced by lysophosphatidylcholine is preferentially absorbed into the brain instead of free DHA. DHA accumulates in nerve cell membrane and is involved in the prevention of dementia. The antioxidative and anti-inflammatory properties of DHA and DHA metabolites as well as their ability to decrease amyloid beta (Aβ) 42 production were implicated in the improvement of cognitive function. The antioxidant effect of DHA, the inhibition of neuronal cell death by Aβ peptide, improvement in learning ability, and enhancement of synaptic plasticity may contribute to the prevention of dementia induced by ischemic stroke.
Topics: Humans; Alzheimer Disease; Docosahexaenoic Acids; Amyloid beta-Peptides; Dementia, Vascular; Ischemic Stroke; Endothelial Cells; Antioxidants; Stroke
PubMed: 37028469
DOI: 10.1016/j.prostaglandins.2023.106733 -
Journal of the College of Physicians... Oct 2023To determine the clinical impact of preventive nursing on children with hypospadias and the intervention effect on postoperative complications. (Comparative Study)
Comparative Study Randomized Controlled Trial
OBJECTIVE
To determine the clinical impact of preventive nursing on children with hypospadias and the intervention effect on postoperative complications.
STUDY DESIGN
Comparative study. Place and Duration of the Study: Department of Urology Surgery, Beijing Children's Hospital Affiliated to Capital Medical University Baoding Hospital, Hebei, China, from August 2019 to July 2021.
METHODOLOGY
Children with hypospadias who received elective surgery were randomly divided into two groups of forty cases each. The control group received traditional specialised nursing care during the perioperative period, the study group administered preventive care on the control basis. The postoperative rehabilitation, VAS, anxiety and depression score, postoperative complications, and nursing satisfaction were compared between the two groups.
RESULTS
The time of first bowel movement, extubation, and hospitalisation in the study group were significantly shorter than in the control group, with statistically significant value (p<0.001). After intervention, the SAS and SDS in the study group were significantly lower than those in the control group, and the difference was statistically significant (p<0.05). The incidence of complications in the study group was 7.50%, lower than the 25% of control group (p = 0.034). The postoperative VAS scores of the study group were significantly lower than those of control group at 6 and 24 hours (p<0.05). Besides, nursing satisfaction in the study group was 97.50%, higher than the 82.50% of the control group (p = 0.025).
CONCLUSION
Preventive nursing had a reliable nursing effect on children undergoing hypospadias surgery, which can reduce postoperative complications, alleviate postoperative pain, improve postoperative anxiety and depression, enhance nursing experience, and promote postoperative recovery.
KEY WORDS
Preventive care, Hypospadias in male children, Urethroplasty, Complication, Clinical effect.
Topics: Child; Humans; Male; Anxiety; Hypospadias; Pain, Postoperative; Postoperative Complications; Urethra
PubMed: 37804022
DOI: 10.29271/jcpsp.2023.10.1153 -
Evidence-based Dentistry Jun 2024Three electronic databases (Pubmed, Embase and the Cochrane Library) were searched in December 2022, and again for additional literature on 3-5th January 2023. Reference... (Review)
Review
DATA SOURCES
Three electronic databases (Pubmed, Embase and the Cochrane Library) were searched in December 2022, and again for additional literature on 3-5th January 2023. Reference lists of relevant systematic reviews were hand searched for other eligible studies for inclusion.
STUDY SELECTION
Randomised controlled clinical trials and controlled clinical trials conducted on children (aged ≤ 18 years), conducted between 1974-2022 and available in English, were eligible for inclusion. Studies were excluded if caries was not an outcome, the control group was not sufficient, they were lab-based studies or studies where xylitol delivery was not a sweet or chewing gum and where the xylitol product contained a component such as fluoride which may influence the outcomes.
DATA EXTRACTION AND SYNTHESIS
Four calibrated reviewers independently screened titles and abstracts, and disagreements were resolved via group discussion. Preventative effect was determined by comparing the mean caries increment in the control and intervention groups, producing a preventative fraction. A total of 617 titles were initially screened for relevance. After duplicate removal, 268 abstracts were screened and 16 full text articles reviewed, with one more study then excluded. 10 studies investigated xylitol-containing chewing gum, and six looked at xylitol candy (one did both). Eight included studies were randomised controlled trials. Data extraction was undertaken by two reviewers.
RESULTS
3466 participants were included in the 10 studies that investigated xylitol chewing gum, and all 10 studies reported a statistically significant preventive effect compared to a no chewing gum or placebo control. In 9 studies, the preventive fraction was clinically significant. The six studies investigating xylitol candies contained a total of 1023 participants, and only one study demonstrated a significant preventative effect.
CONCLUSIONS
There is some evidence that incorporating xylitol chewing gum daily has a caries-reducing effect in those with a moderate-to-high baseline caries level. This effect was not present for xylitol sweets.
Topics: Xylitol; Chewing Gum; Dental Caries; Humans; Child; Sweetening Agents; Adolescent; Randomized Controlled Trials as Topic; Cariostatic Agents; Child, Preschool
PubMed: 38796554
DOI: 10.1038/s41432-024-01018-2 -
Nursing Outlook 2024The high burden of pressure ulcers (PUs) in Sub-Saharan Africa (SSA), coupled with the limited resources, underscores the need for preventive and context-specific... (Review)
Review
BACKGROUND
The high burden of pressure ulcers (PUs) in Sub-Saharan Africa (SSA), coupled with the limited resources, underscores the need for preventive and context-specific treatment strategies.
PURPOSE
Therefore, the purpose of this systematic review was to establish and elucidate PU prevention and treatment interventions tested in SSA.
METHODS
This systematic review of the literature used, PRISMA to guide the search.
FINDINGS
The review identified nine studies on PU prevention (three) and treatment (six). Low-cost interventions assembled from locally available materials and multifaceted policies significantly prevented and treated PUs. The interventions included wound dressing agents, simple negative pressure suction devices that significantly treated PUs, and water-based bed surfaces.
DISCUSSION
There were gaps in the interventions that have been proven successful in other global settings.
CONCLUSION
In SSA, there is a need for nurses to tailor, test, and disseminate findings from evidence-based projects for PU prevention that have been successful in similar settings.
Topics: Pressure Ulcer; Humans; Africa South of the Sahara; Female; Male; Adult; Middle Aged
PubMed: 38490058
DOI: 10.1016/j.outlook.2024.102151